Functional outcome of diaphyseal fractures of femur managed by closed intramedullary interlocking nailing in adults

Abstract

Objective: To study the effectiveness, advantages, disadvantages and failure rates of closed intramedullary interlocking nailing of daiphyseal fractures of the femur in adults.

Materials and methods: A total of 30 cases of diaphyseal femur fractures in adults, who have been treated with closed intramedullary interlocking nailing were studied from 2008 - 2010. Data was analyzed both with regards to the clinical and radiological outcome to evaluate the effectiveness, functional outcome and morbidity associated with the procedure.

Results: Average age of the patient was 27.4 years with male preponderance. Road traffic accidents were the most common mode of injury; middle third shaft fractures were most commonly seen (56.66%); comminuted and transverse fractures (63.33%) were the commonest fracture pattern. The union rate was 96.6%. Five patients had superficial infection, four had shortening of limb, and in two cases union was delayed. Excellent to good results were seen in 86.6% cases as per modified Klaus and Klemm criteria.

Conclusion: Closed intramedullary interlocking nailing has now become the treatment of choice for closed diaphyseal fractures of femur in adults, especially those with high comminution, long spiral, and segmental fractures. Interlocking nail offers the added advantages of early joint mobilization, early weight bearing, early muscle rehabilitation, shortened hospital stay, and most importantly early return to work and prefracture state.